Provider Demographics
NPI:1467444893
Name:STERLING PATHOLOGY MED CORP
Entity Type:Organization
Organization Name:STERLING PATHOLOGY MED CORP
Other - Org Name:STERLING PATHOLOGY NATL LABS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHENGGAO
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-799-5518
Mailing Address - Street 1:3020 OLD RANCH PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2765
Mailing Address - Country:US
Mailing Address - Phone:562-799-5518
Mailing Address - Fax:562-799-5544
Practice Address - Street 1:3020 OLD RANCH PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-2765
Practice Address - Country:US
Practice Address - Phone:562-799-5518
Practice Address - Fax:562-799-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CLF11783OtherCA LAB LICENSE
CADOAG22P1Medicare ID - Type Unspecified